Bilateral Rasmussen's Aneurysms: A Rare Etiology of Hemoptysis

Rasmussen's aneurysm is a pseudoaneurysm of a pulmonary artery branch occurring adjacent to or within a tuberculous cavity and represents a rare but potentially fatal cause of hemoptysis. Bilateral involvement is exceptionally uncommon and sparsely reported in medical literature. This case report discusses a 45-year-old female with pulmonary tuberculosis on antitubercular therapy who presented with recurrent hemoptysis and progressive breathlessness. Computed tomography pulmonary angiography demonstrated multiple bilateral cavitary lesions with associated small aneurysmal dilatations arising from pulmonary artery branches, consistent with bilateral Rasmussen's aneurysms. The patient underwent selective endovascular coil embolization with successful control of bleeding. Follow-up imaging showed postprocedural changes along with residual features of active infection. This case highlights the importance of considering pulmonary artery pseudoaneurysm in tuberculosis patients with recurrent hemoptysis and emphasizes the crucial role of CT pulmonary angiography and endovascular therapy in diagnosis and management of this rare but life-threatening condition.